title: Deployment-related sequelae and treatment utilization in rural and urban war veterans in Hawaii.
abstract: This study compared common deployment-related health issues and correlates of mental health service utilization among rural and urban veterans of Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND) living in Hawaii. Frequency of utilization of a broad range of mental health resources, including clergy/spiritual leaders, videoconference/online programs, and traditional/alternative healers, was also characterized. A random sample of 116 rural and 117 urban ethnoracially diverse veterans completed a mail survey. Rural veterans were more likely than urban veterans to meet screening criteria for posttraumatic stress disorder (PTSD), deployment-related concussion with persistent postconcussive symptoms, and alcohol use problems. Over one third of veterans who desired help for a mental health problem reported no current use of any services. Rural veterans were more likely than urban veterans to have accessed Veteran Readjustment Centers, but they did not differ with respect to utilization of other services. Correlates of mental health service utilization included higher education, PTSD, and lower mental-health-related quality of life. Results of this study underscore the need for dissemination efforts to enable OEF/OIF/OND veterans to access mental health resources.
authors.affiliation: National Center for Posttraumatic Stress Disorder, Pacific Islands Division, VA Pacific Island Health Care System.
authors.forename: Julia M
authors.identifier: 0000-0002-2876-6783
authors.initials: JM
authors.lastname: Whealin
authors.affiliation: Myron B. Thompson School of Social Work, University of Hawaii.
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Stotzer
authors.affiliation: National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Pacific Island Health Care System.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Pietrzak
authors.affiliation: Women's Health Sciences Division, National Center for Posttraumatic Stress Disorder, VA Boston Healthcare System.
authors.forename: Dawne
authors.initials: D
authors.lastname: Vogt
authors.affiliation: Native Domain, Department of Veterans Affairs Office of Rural Veterans Rural Health Resource Center-Western Region.
authors.forename: Jay
authors.initials: J
authors.lastname: Shore
authors.affiliation: National Center for Posttraumatic Stress Disorder, Pacific Islands Division, VA Pacific Island Health Care System.
authors.forename: Leslie
authors.initials: L
authors.lastname: Morland
authors.affiliation: National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Southwick
mesh_terms: D000328:Adult; D019973:Alcohol-Related Disorders / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006254:Hawaii / Q000453:epidemiology; D019538:Health Care Surveys; D054624:Health Status Disparities; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D038223:Post-Concussion Syndrome / Q000453:epidemiology*; D011788:Quality of Life; D012424:Rural Population / Q000706:statistics & numerical data; D057566:Self Report; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D014505:Urban Population / Q000706:statistics & numerical data; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data*